Medicare Increases Cancer Drug Coverage

Medicare is now willing to pay for “off-label” cancer drug treatments.  While sure to increase Medicare spending, and cause a certain amount of controversy, Medicare will now pay for treatment using drugs that have received FDA approval – but not for use as a cancer treatment.

“In some instances … the medical community may have scientific
evidence that supports using a drug to treat a disease even if the
drug’s FDA-approved label does not include those clinical conditions,”
Medicare explained in a June 5 news release describing the policy.

Oncologists appear to strongly support the new rules, which went in to effect this past autum.  While “off-label” prescribing has been a standard practice for some time, not all groups are supportive:

“I’m not sure I would say it’s a bad thing, but I think it was
ill-advised and needs to be re-evaluated,” said Steven Findlay, a
health policy analyst for Consumers Union, publishers of Consumer
Reports. “We think it’s better to be cautious. Evidence shows that some
of these drugs extend life by a very small amount and at great cost.”

Medicare notes it is not obligated to pay for the treatments.  Physicians must still provide evidence the treatments are “reasonable and necessary”.